Abstract P618: Visceral and Subcutaneous Adipokine Expression and Serum Adipokine Levels Are Differentially Associated With Metabolic Risk

Background: Adipokines mediate many metabolic effects of adipose tissue. While regional body composition is associated with metabolic risk, it is unclear if metabolic risk associations differ for adipokine expression in visceral and subcutaneous tissue and adipokine concentrations in the circulation. Methods: We obtained visceral and subcutaneous fat samples, and pre-surgical serum samples from Geisinger Obesity Registry patients undergoing bariatric surgery. We used real-time PCR to quantify mRNA expression of adipokines (adiponectin, leptin, leptin/adiponectin ratio) in fat samples, and targeted assays (ELISA) to measure serum adipokines. Using multivariable linear regression, we evaluated the individual and combined associations of visceral, subcutaneous and serum adipokines (per-1-SD and tertiles) with a metabolic syndrome (MetS) severity Z-score. Results: 181 participants (mean age 45 years, mean BMI 47 kg/m 2 , 85% female) with available fat and serum samples were included. Visceral, subcutaneous and serum adipokines were all weakly correlated (all ρ<0.15). Each 1-SD higher visceral adipokine expression and serum adipokine concentrations were significantly associated with MetS z-score, whereas no associations with MetS z-score were seen for subcutaneous adipokine expression (Table). Individuals in the top tertile of leptin/adiponectin ratio in serum only (ß=0.29, 95%CI: 0.01, 0.57) or in visceral fat only (ß=0.37, 95%CI: 0.08, 0.66) had higher metabolic risk than those in the top tertile in neither visceral fat nor serum (Figure). However, those in the top leptin/adiponectin tertile in both in visceral fat and serum had the greatest metabolic risk (ß=0.78, 95%CI: 0.46, 1.11). Conclusion: Visceral, but not subcutaneous, adipokine expression provides complementary information to serum adipokines on metabolic risk. This indicates significant differences in the physiologic impact of regional adipose tissue and highlights adipokines as a potential target for modifying cardiometabolic risk.